9612 19TH AVE SE F 2023-12-18 - Laserfiche WebLink

Intake & Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT # FJ�-- O(D3 BUILDING Intake OK by: -4 Date: %4�J/Zo2,Z Intake Comments: ❑ Route to Commercial Building ❑ Route to Residential Building ❑ Make this a "W" Permit Bldg/TI/Addn/Rem Size Garage/Accessory Struct. Size b t SF Number of Stories 3 Basement RNo ❑Yes , Fin / Unfin Type of Construction Occupancy Group �/LC Occupancy Load Fire Sprinklers: ❑Update Existing New System ❑Not Req'd Reason Sprinklers Required: Jvwx/fow 03/3.1 Fire Alarm: ❑Update Existing El New System R]Not Req'd Reason Fire Alarm Required: RCW 64.55 MF worksheet req'd for permit? ❑173 Yes I No Add'I RCW 64.55 docs required prior to final? ❑Yes ®No VALUATION CALCULATION: Total $ 3 ?jT l0 /5`7 3 SF x l30 56 ! k S"I Additional Notes: Approved By: i Date: FIRE DEPARTMENT Separate / Deferred Submittals Required: Fire Sprinklers ❑Fire Alarm ❑Other: Additional Notes: Fire Dept. Fees: ❑ Review of As -Built Plans - NO FIRE FEE ❑ Minimal or No Fire Scope - NO FIRE FEE Review / Inspection Scope - ADD FIRE FEE Approved By. Date: ELECTRICAL/PLUMBING Additional Notes: Approved By: Date: PLANNING Intake OK by: Assign To: Date: Intake Comments: ❑ Attach to Project No. ❑ Route to Historic Reviewer ❑ OK to Route to Other Departments ❑ Hold in Planning File Drawer Zone Overlay/Agreement Nonresidential Use Residential Use Proposed No. of Dwelling Units: Total No. of Dwelling Units: Planning/Landscape Inspection Required before Final? ❑Yes []No "In Lieu" Fee: Type: Amount $ School Impact Fee: Total $ `�Ji O Calculated: ,3010 Credit: �erett School Dist ❑Mukilteo School Dist Additional Notes: /Qb� -3 Z Z i, l- /�c /'x 6 _Aq6 1y 3 Approved By: Date: X Z3 PUBLIC WORKS Intake OK by: Date: C) - >`Z - Z; 7 •- ............................................................................I......................... ^...v _..__.. Intake Comments: PWWorksheet Needed if. • ❑Sys Dev Eva[ Traffic Mit Eval ❑Site Work or Drainage Proposed ❑Backflow Prevention for high hazard: i(dental, medical, animals, mortuary, hospital, isupportive housing) ................ ............................... .................................................................................. ._........ ..............._.. ❑Route this folder for PW Review at end --- PW Review Worksheet ,®This project also has a separate concurrent PW Review (Green Folder) AND ❑Create Green Folder 15Submitted Previously ❑Deferred This Permit is Approved by Public Works 1A See PW Review Worksheet and associated attached items 10 A Separate PW Permit is Required (Permit #: PWa� AND ❑ Is located in this folder 0 Is in a Separate Green Folder Qoin with this folder for permit issuance) ❑ WIII be Issued separately (Separate Green Folder, PW issued ahead of Bldg) ❑ Public Works has no scope --- PW Not Required Additional Notes: Approved By: Date-1 M 76 Z-2---